 | Brain Food is a project to drip feed clinical knowledge (in the form of mock SAQs) to satisfy those hungry neurons. Sources are SA/NT Trial Exam 2021.2 and Monash 2022.1. Answers are prone to ageing. Leave a comment if you don't understand or something doesn't seem right... PS we don't use the mock questions uploaded to ACEMs official mocks |
You are working in a rural Emergency Department where a 27 year old with a swollen leg and shortness of breath presents to your emergency department. Your resident has reviewed the patient but asks you some questions regarding the diagnostic strategy for a Pulmonary Embolus.
1. List five (5) hereditary risk factors for a pulmonary embolism. (5 marks)
- Prothrombin gene mutations
- Antithrombin III deficiency
- Protein C deficiency
- Protein S deficiency
- Factor V Leiden mutation
2. In the simplified Wells Score, list three (3) of the features with the highest points. (3 marks)
- 1.5 points for HR >100
- 1.5 points for immobilisation/surgery in the last 4 weeks
- 1.5 points for previous PE/DVT
3. List one diagnostic finding for each of the following tests in pulmonary embolism. (4 marks)
- ECG: S1 Q3 T3 pattern, T wave inversion in III with RAD, RBBB, p pulmonale, RVH and strain
- ABG: hypoxia on room air, increased A-a gradient (>20)
- Echocardiogram: RV dilation and hypokinesia, McConnell's sign, thrombus visible in RV or main pulmonary artery
- Chest x-ray: Westermark's sign, Hampton's hump, pulmonary infarct
RSS Feed
